Community case management of lower chest indrawing pneumonia with oral amoxicillin in children in Kenya
© 2018 World Health Organization; licensed by Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd..
AIM: To determine the accuracy and effectiveness of community health workers (CHWs) when compared to trained nurses for management of pneumonia in Kenyan children.
METHODS: In Homabay County in western Kenya, children 2-59 months of age with lower chest indrawing pneumonia were identified, classified and treated by CHWs with oral amoxicillin (90 mg/kg per day) for five days at home. Trained nurses visited the child within 24 hours to verify diagnosis; and on day 4 and 14 to assess treatment outcomes.
RESULTS: CHWs identified 1906 children with lower chest indrawing pneumonia. There was an 88.7% concordance in classification and treatment for lower chest indrawing pneumonia by CHWs compared to nurses. Children with moderate malnutrition (OR 1.68; 95% CI: 1.22-2.30), comorbidities such as diarrhoea or malaria (OR 1.55; 95% CI: 1.32-1.81) or an additional day of delay in care seeking (OR 1.06; 95% CI: 1.02-1.10) were more likely to have an incorrect classification of lower chest indrawing by the CHW. Comorbidity (OR 1.66; 95% CI: 1.12-2.48) and fast breathing (OR 4.66; 95% CI: 1.26-17.27) were significantly associated with treatment failure on day 14.
CONCLUSION: CHWs can correctly manage lower chest indrawing pneumonia even in high-mortality settings, such as western Kenya, in sub-Saharan Africa.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:107 Suppl 471 |
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| Enthalten in: |
Acta paediatrica (Oslo, Norway : 1992) - 107 Suppl 471(2018) vom: 20. Dez., Seite 44-52 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Onono, Maricianah [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 19.11.2019 Date Revised 08.04.2022 published: Print ANZCTR: ACTRN12614000208606 Citation Status MEDLINE |
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| doi: |
10.1111/apa.14405 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM292004176 |
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| 500 | |a Date Revised 08.04.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a ANZCTR: ACTRN12614000208606 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2018 World Health Organization; licensed by Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd. | ||
| 520 | |a AIM: To determine the accuracy and effectiveness of community health workers (CHWs) when compared to trained nurses for management of pneumonia in Kenyan children | ||
| 520 | |a METHODS: In Homabay County in western Kenya, children 2-59 months of age with lower chest indrawing pneumonia were identified, classified and treated by CHWs with oral amoxicillin (90 mg/kg per day) for five days at home. Trained nurses visited the child within 24 hours to verify diagnosis; and on day 4 and 14 to assess treatment outcomes | ||
| 520 | |a RESULTS: CHWs identified 1906 children with lower chest indrawing pneumonia. There was an 88.7% concordance in classification and treatment for lower chest indrawing pneumonia by CHWs compared to nurses. Children with moderate malnutrition (OR 1.68; 95% CI: 1.22-2.30), comorbidities such as diarrhoea or malaria (OR 1.55; 95% CI: 1.32-1.81) or an additional day of delay in care seeking (OR 1.06; 95% CI: 1.02-1.10) were more likely to have an incorrect classification of lower chest indrawing by the CHW. Comorbidity (OR 1.66; 95% CI: 1.12-2.48) and fast breathing (OR 4.66; 95% CI: 1.26-17.27) were significantly associated with treatment failure on day 14 | ||
| 520 | |a CONCLUSION: CHWs can correctly manage lower chest indrawing pneumonia even in high-mortality settings, such as western Kenya, in sub-Saharan Africa | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Chest indrawing | |
| 650 | 4 | |a Community health workers | |
| 650 | 4 | |a Integrated community case management | |
| 650 | 4 | |a Pneumonia | |
| 650 | 4 | |a Sub-Saharan Africa | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 650 | 7 | |a Amoxicillin |2 NLM | |
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| 700 | 1 | |a Abdi, Mohammed |e verfasserin |4 aut | |
| 700 | 1 | |a Mutai, Kennedy |e verfasserin |4 aut | |
| 700 | 1 | |a Asadhi, Elijah |e verfasserin |4 aut | |
| 700 | 1 | |a Nyamai, Rachel |e verfasserin |4 aut | |
| 700 | 1 | |a Okoth, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Qazi, Shamim Ahmad |e verfasserin |4 aut | |
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